Chapman B.,University of Sydney |
Slavin M.,Victorian Infectious Diseases Service at the Doherty Institute for Infection and Immunity |
Marriott D.,St Vincents Hospital |
Halliday C.,Westmead Hospital |
And 82 more authors.
Journal of Antimicrobial Chemotherapy | Year: 2017
Objectives: Knowledge of contemporary epidemiology of candidaemia is essential.We aimed to identify changes since 2004 in incidence, species epidemiology and antifungal susceptibilities of Candida spp. causing candidaemia in Australia. Methods: These data were collected from nationwide active laboratory-based surveillance for candidaemia over 1 year (within 2014-2015). Isolate identification was by MALDI-TOF MS supplemented by DNA sequencing. Antifungal susceptibility testing was performed using Sensititre YeastOneTM. Results: A total of 527 candidaemia episodes (yielding 548 isolates) were evaluable. The mean annual incidence was 2.41/105 population. The median patient agewas 63 years (56% of cases occurred in males). Of 498 isolates with confirmed species identity, Candida albicans was the most common (44.4%) followed by Candida glabrata complex (26.7%) and Candida parapsilosis complex (16.5%). Uncommon Candida species comprised 25 (5%) isolates. Overall, C. albicans (>99%) and C. parapsilosis (98.8%) were fluconazole susceptible. However, 16.7% (4 of 24) of Candida tropicalis were fluconazole- and voriconazole-resistant and were non-WT to posaconazole. Of C. glabrata isolates, 6.8% were resistant/non-WT to azoles; only one isolate was classed as resistant to caspofungin (MIC of 0.5 mg/L) by CLSI criteria, but was micafungin and anidulafungin susceptible. There was no azole/ echinocandin co-resistance. Conclusions:We report an almost 1.7-fold proportional increase in C. glabrata candidaemia (26.7% versus 16% in 2004) in Australia. Antifungal resistance was generally uncommon, but azole resistance (16.7% of isolates) amongst C. tropicalis may be emerging. © The Author 2016.
Scripcaru G.,Royal Darwin Hospital |
Zardawi I.M.,Pathology North |
Zardawi I.M.,University of Newcastle
International Journal of Surgical Oncology | Year: 2012
Mammary ductal carcinoma in-situ (DCIS), a malignant appearing lesion on cytological and histological grounds, is in fact a non-obligate precancer. DCIS is difficult to manage and is sometimes treated more aggressively than invasive carcinoma. Although most DCIS classifications take into account the architectural growth pattern, when it comes to architecture, the literature is full of contradictory information. We examined 289 breast cancers and found DCIS in 265 of the cases. The majority of the DCIS cases were seen in the setting of invasive cancer and only 9% of the cases represented pure DCIS with no invasive cancer. The DCIS commonly displayed a mixed pattern with micropapillary, cribriform and solid components with the micropapillary type being the rarest, occurring seldom on its own. A continuum of growth with a micropapillary pattern evolving into a cribriform type could be seen in some of the cases. This may explain some of the conflicting information, in the literature, regarding the different architectural types of DCIS. The comedo-pattern of necrosis could be seen in all types of DCIS. We therefore conclude that the study of the determinants of growth pattern in DCIS would be the key to unravelling the diverse, often non-concordant evidence one encounters in the literature. © 2012 Gabriel Scripcaru and Ibrahim M. Zardawi.
PubMed | Pathology North, Monash University, Lady Cilento Childrens Hospital and Sullivan Nicolaides Pathology, Princess Margaret Hospital for Children and 5 more.
Type: Journal Article | Journal: Internal medicine journal | Year: 2016
The incidence of Clostridium difficile infection (CDI) continues to rise, whilst treatment remains problematic due to recurrent, refractory and potentially severe nature of disease. The treatment of C. difficile is a challenge for community and hospital-based clinicians. With the advent of an expanding therapeutic arsenal against C. difficile since the last published Australasian guidelines, an update on CDI treatment recommendations for Australasian clinicians was required. On behalf of the Australasian Society of Infectious Diseases, we present the updated guidelines for the management of CDI in adults and children.
Wong-Brown M.W.,Hunter Medical Research Institute |
Meldrum C.J.,Pathology North |
Carpenter J.E.,University of Sydney |
Clarke C.L.,University of Sydney |
And 5 more authors.
Breast Cancer Research and Treatment | Year: 2015
Triple-negative breast cancers (TNBC) lack expression of oestrogen, progesterone and HER2 receptors. The gene expression profiles of TNBCs are similar to those of breast tumours in women with BRCA1 mutations. Reports to date indicate that up to 20 % of TNBC patients harbour germline BRCA mutations; however, the prevalence of BRCA mutations in TNBC patients varies widely between countries and from study to study. We studied 774 women with triple-negative breast cancer, diagnosed on average at age 58.0 years. Samples of genomic DNA were provided by the Australian Breast Cancer Tissue Bank (ABCTB) (439 patients) and by the Department of Genetics and Pathology of the Pomeranian Medical University (335 patients). The entire coding regions and the exon–intron boundaries of BRCA1 and BRCA2 were amplified and sequenced by next-generation sequencing. We identified a BRCA1 or BRCA2 mutation in 74 of 774 (9.6 %) triple-negative patients. The mutation prevalence was 9.3 % in Australia and was 9.9 % in Poland. In both countries, the mean age of diagnoses of BRCA1 mutation carriers was significantly lower than that of non-carriers, while the age of onset of BRCA2 mutation carriers was similar to that of non-carriers. In the Australian cohort, 59 % of the mutation-positive patients did not have a family history of breast or ovarian cancer, and would not have qualified for genetic testing. The triple-negative phenotype should be added as a criterion to genetic screening guidelines. © 2015, Springer Science+Business Media New York.